Abstract WP27: Sex-Related Differences in Disability Adjusted Life Years After Mechanical Thrombectomy for Acute Ischemic Stroke
Bibliographic record
Abstract
Background: Randomized trials have shown that mechanical thrombectomy improves 3-month disability outcomes after acute ischemic stroke for both women and men. However post-stroke disability and reduced life expectancy (LE) persists beyond 3 months, and lifetime effects of thrombectomy might differ between men and women. Methods: We analyzed patients treated with the Solitaire stent retriever in the TripleS database (pooled patient-level data from the SWIFT, STAR, and SWIFT-PRIME trials). Years of optimum life after thrombectomy were defined as disability adjusted life-year (DALYs), using the methodology of the World Health Organization Global Burden of Disease Project. For each patient, LE was calculated based on age and sex-specific values, and known degree of modification of LE by modified Rankin Scale (mRS) status at 3 months post-stroke. Years of optimum life lost due to disability were calculated by projecting mRS status at 3 months through the remaining LE. Results: Among 389 patients treated with ET, 55% were female, and median NIHSS was 17 [8-28]. There were no differences between females vs. males in presenting deficit severity (NIHSS 17 vs. 17, p=0.21), occlusion location (69% vs. 64% M1, p=0.62), presenting infarct extent (ASPECTS 9 vs. 8, p=0.24), rate of substantial reperfusion (TICI 2b/3, 87% vs. 83%, p=0.37), onset to reperfusion time (277 vs. 306 mins, p=0.46). Women presented at advanced mean age compared to men (69 vs 64, p<0.001). Rates of functional independence at 90 days (53% vs. 56%, p=0.54) were similar in men and women. Without adjusting for age at presentation, years of optimal life (DALYs) following thrombectomy were similar between women and men (9.3 vs 9.6 years, p=0.48). After adjusting for differing ages at presentation, women had more years of optimal life (DALYs) following thrombectomy, 10.6 vs 8.5 years (p<0.001). Conclusions: In age-standardized comparisons, women experience two more optimal years than men following mechanical thrombectomy for acute ischemic stroke. Greater life expectancies of women, coupled with similar disability outcome distributions, yield substantially greater years of optimal life after intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".